Take the challenge. C—When an insurance carrier requests the medical record for a service performed, the practice should send all pertinent information to support the medical necessity of that service. For example, if the drug requires that a patient first be tested for tuberculosis and the patient should be on methotrexate or leflunomide, the note…
Coding Corner Questions: An Audit Record Request Quiz
A private insurance carrier sends an audit request letter to a rheumatology practice to review its infusion medical records for the past 30 dates of service. What information should the practice send to the carrier? Only the infusion notes The complete notes for the requested dates of service only The complete notes for the requested…
Practice Management Workshop at the 2019 ACR/ARP Annual Meeting
Join us in Atlanta Nov. 8–13 for the 2019 ACR/ARP Annual Meeting. Member registration is now open, including registration for the annual pre-meeting practice management workshop: Practice Matters—Navigating a Path to Success! The 2019 workshop will focus on key practice matters. The goal of the pre-meeting workshop is to address how best to manage your…
ARP Collaborates with EULAR’s Health Professionals in Rheumatology
The Association of Rheumatology Professionals (ARP) and European League Against Rheumatism Health Professionals in Rheumatology (EULAR HPR) are, to a great extent, working toward addressing the same long-term goals and challenges. Despite differences in healthcare services, culture, organization and economical aspects across the Atlantic Ocean, we can help each other overcome these challenges and learn…
Scientist Development Award Winner Probes Ethnic Disparities in Lupus
Recipient of a Rheumatology Research Foundation Scientist Development Award, Ashira Blazer, MD, focuses her research on racial and ethnic disparities in lupus. She looks beyond socioeconomic differences, differences in lifestyles and access to care to better understand the biologically determined differences behind disparate outcomes. With funding from the Foundation, she was able to investigate the…
ACR Introduces Prior Authorization & Step Therapy Resolutions at AMA Meeting
This year, the American Medical Association (AMA) convened its annual House of Delegates (HOD) meeting June 8–12 in Chicago to discuss emerging and public health issues. Among the many policies and practices discussed: two resolutions put forth by the ACR on behalf of ACR and ARP members, one concerning prior authorization and another concerning step…
Coding Corner Answer: Are Brief Phone Calls with Patients Billable?
Take the challenge. Scenario B is billable and should be coded as G2012. The ICD-10 is M06.09. As of January 2019, the Centers for Medicare & Medicaid Services has allowed a new code to be billed for a brief communication for virtual check-in by a physician or a qualified healthcare professional who can provide an…
Coding Corner Question: Are Brief Phone Calls with Patients Billable?
Scenario A A 67-year-old, female Medicare patient diagnosed with rheumatoid arthritis, previously without rheumatoid factor, calls the rheumatologist’s office to get an update on the lab tests taken when she was last seen in the office two weeks before. The patient was tested for C-reactive protein (CRP), rheumatoid factor (RF), anti-cyclic citrullinated peptide (anti-CCP) and…
Email & Text in the World of HIPAA
The world we live in necessitates information be communicated in a quick and easy manner. This remains true in the healthcare setting. The ability to text or email staff and patients has become a priority for many healthcare entities. However, maintaining patient privacy and confidentiality is essential to ensure we meet compliance standards. Although emailing…
Update on Accelerating Medicines Partnership
The Accelerating Medicines Partnership (AMP) was launched in 2014 as a public-private partnership to spur development of new therapeutic options for rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). Five years in, this unprecedented public-private effort is achieving its major milestones and yielding tools to accelerate potential new drug discoveries. The Rheumatology Research Foundation is…
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